Abstract

The original windlass mechanism describes a one-to-one coupling between metatarsal joint dorsiflexion and medial longitudinal arch rise. The description assumes a sufficiently stiff plantar aponeurosis and absence of foot muscle activity. However, recent research calls for a broader interpretation of the windlass mechanism that accounts for an extensible plantar aponeurosis and active foot muscles. In this study, we investigate the rise of the arch in response to toe dorsiflexion when sitting, standing, and walking to discuss the windlass mechanism’s contributions in static and dynamic load scenarios. 3D motion analysis allowed a kinematic investigation of the rise and drop of the arch relative to the extent of toe dorsiflexion. The results suggest that static windlass effects poorly predict the relationship between arch dynamics and metatarsophalangeal joint motion during dynamic load scenarios, such as walking. We were able to show that toe dorsiflexion resulted in an immediate rise of the longitudinal arch during sitting and standing. In contrast, a decrease in arch height was observed during walking, despite toe dorsiflexion at the beginning of the push-off phase. Further, the longitudinal arch rose almost linearly with toe dorsiflexion in the static loading scenarios, while the dynamic load scenario revealed an exponential rise of the arch. In addition to that, the rate of change in arch height relative to toe motion was significantly lower when sitting and standing compared to walking. Finally, and most surprisingly, arch rise was found to correlate with toe dorsiflexion only in the dynamic loading scenario. These results challenge the traditional perspective of the windlass mechanism as the dominating source of foot rigidity for push-off against the ground during bipedal walking. It seems plausible that other mechanisms besides the windlass act to raise the foot arch.

Highlights

  • The human foot has evolved numerous anatomical adaptations in response to the functional demands of bipedal locomotion [1]

  • While sitting and standing showed a constant rise of the longitudinal arch with increasing toe angles, the arch did not appear to rise before a toe dorsiflexion angle of 8.51 ± 3.46 ̊ during walking

  • The results suggest that static windlass effects poorly predict the relationship between arch dynamics and metatarsophalangeal joint motion during dynamic load scenarios. (A-C) show the mean changes in navicular height in relation to toe dorsiflexion ( ̊). (D-F) display the changes in navicular height relative to the toe dorsiflexion

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Summary

Introduction

The human foot has evolved numerous anatomical adaptations in response to the functional demands of bipedal locomotion [1]. During the propulsive phase of walking (from heel lift to toeoff), the dorsally oriented metatarsal heads in the human forefoot are thought to increase the range of dorsiflexion motion at the MTP joints by providing more dorsal articular surface area on which the proximal phalangeal base can slide [6]. Hicks first described the windlass mechanism in 1954 as a one-to-one coupling between metatarsal joint dorsiflexion and medial longitudinal arch rise [7]. According to his description, dorsiflexion of the toes tightens the plantar aponeurosis and, thereby, pulls the calcaneus and metatarsal heads towards each other (Fig 1). It is thought that the mechanism counters compressive forces from above and stiffens the foot [7]

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